From the Heart: Organ Donation around the world

Despite repeated campaigns to get the public to sign up for organ donation, on average the number of deceased organ donors in the rest of the EU is higher than in Britain. Although if figures for live donation are taken in to account the UK does slightly better, live donors can only donate a limited number of organs. In Spain the number of organ donations, per one million people, is double that of the UK.

The main reason behind the UK's poor organ donation rates is that Britain has an "opt-in system" where a potential donor is required to signal that they wish to join the national donor register. Many Countries in the EU, like Spain, have an "opt-out" system where people are required to signal when they do not wish to donate.

An NHS organ donor card, Spain has nearly double the number of organ donations as they use an 'opt-out' system
An NHS organ donor card, Spain has nearly double the number of organ donations as they use an 'opt-out' system Credit: Clive Gee/PA Wire

Some people have argued that having an opt-out system does not mean you instantly get more donors. Greece has a very low number of donors even though they have an opt-out system. Instead it is believed that culture, management and selling the emotional benefits of organ donation are just as important.

Organ donations per 1 million people:

  • Spain: 35.5
  • USA: 26.9
  • Latvia: 23.9
  • France: 23.2
  • Italy: 21.7
  • Finland: 20.7
  • Netherlands: 17.8
  • Hungary: 17.8
  • Croatia: 16.3
  • Norway: 16.3
  • Germany: 15.3
  • Sweden: 15.1
  • Poland: 13
  • UK: 12.9
  • Slovakia: 11.8
  • Denmark: 11.4
  • Switzerland: 10.7
  • Greece: 7.2

(Statistics from 2007)

Although comparing opt-in and opt-out systems may look clear cut, there are variations. Opt-out systems can be "hard", as in Austria, where the views of close relatives are not taken into account, or "soft", like in Spain, where relatives' views are sought.

As in the UK, America has an opt-in system but still has one of the highest rates of organ donation in the world. There are some notable differences in the way the US system is organised, mainly due to the size of the US compared with the UK.

In the UK the Organ Donor register holds people's information on a database. When a person dies it is used to see if they wished to be a donor with organs which are donated going anywhere in the UK.

In the USA there are 11 regions. Organs go to candidates in the donor's own region. Across the country around 40% of people in the US are on the donor register, the number is just 31% in the UK.

In the UK organ donation is run and promoted by the NHS Blood and Transplant (NHSBT), in the US non-profit organisations promote organ donation in each region.